Document the fee agreement determination on a Form SSA-553 (Special Determination) or another designated form. Include the specific rationale for the fee agreement approval or disapproval. For sample language of a fee agreement determination, see GN 03905.065B.1.

Ensure that there is an active representative flag for an electronic folder or annotate and attach the Form SSA-1128 (Representative Involved) if there is a paper claim(s) file.

The FO forwards the favorable reconsideration determination with the fee agreement to the PC when the FO cannot complete the processing action. The PC follows the procedures in GN 03940.020D to process the claim.

The PC Claims Specialist (CS) or other staff member designated by the PC annotates the "Special Message" fields of the Master Beneficiary Record (MBR).

• •

  To input the special message, access the "Special Message" screen through MONET (or MACADE) and select standard special message 52. Process standard special message 52 to the MBR. Special message 52 will display: "APPOINTED REPRESENTATIVE(S) INVOLVED – SEE RASR, APPREP, AND APPFEE DATA LINES FOR ADDITIONAL INFORMATION."

1. a. 

   Verify through the Registration, Appointment, and Services for Representatives (RASR) database that:

   • •

     If the representative is an attorney, the representative is not sanctioned and is currently qualified to be an attorney representative, per GN 03910.020B.1.; or

   • •

     If the representative is a non-attorney, the representative is not sanctioned and is eligible for direct fee payment, per GN 03920.018.

   • •

     The eligible representative has not waived the fee or direct payment of a fee; and

   • •

     If an eligible representative has validly assigned direct payment of their authorized fee to an entity, that entity is eligible to receive direct payment of fees and has not been placed on the Ineligible for Direct Payment Entity (IDPE) list. For information on assignment of direct payment of fees, see GN 03920.021. For information on the IDPE list, see GN 03920.052.

2. b. 

   Process the non-District Office Final Authorization (non-DOFA) claim through Modernized Claims System (MCS) or A101 or EF101, per the procedures in GN 03940.020E.

3. c. 

   Withhold 25 percent of the past-due benefits or the amount of the authorized fee, if known, if the representative is eligible for and has not waived the fee or direct payment.

4. d. 

   Prepare an Action Control Record (ACR) when a direct fee payment is involved, unless an ACR controlling the award and action was previously created.

• •

  NOT2 for Fee Agreement Type - Leave blank.

  • –

    MCS will automatically code ATY04 to the DW01 when NOT2 "Fee Agreement Type" is blank.

• •

  NOT2 for Fee Agreement% - Leave blank.

• •

  NOT2 for Fee Agreement Amount - Leave blank.

• •

  NOT2 for Last Withholding Date - Code the month before adjudication, see GN 03920.030B.

• •

  On the DW01 screen, receipt in the automatic ATY04 with "XXXXXX."

• •

  Add a new Report of Contact (RPOC) to document disapproval of the fee agreement because no past-due benefits are involved.

• •

  The notice will advise the claimant and the representative(s) that the representative(s) must file a fee petition(s) to receive authorization to charge and collect a fee.

  • –

    For cases adjudicated via MCS earnings computation (EC), no additional notices are required. MCS will generate the correct notice.

  • –

    For cases not adjudicated via MCS EC, include representative notices on the A101/EF101 in the remarks/notice fields and include an ATYR15. Choose fill-in choice D.

• •

  Delete the automated 098/099 diary on the DECI screen. Since there are no past-due benefits, we will not control for cases that do not result in past-due benefits.

• •

  One day after adjudicating the claim via MCS EC, the technician will add a special message to the record showing the representative's name and adding a remark: "Case resulted in no past-due benefits, fee petition, fee paid by claimant."

• •

  For cases adjudicated via MACADE, technicians will provide the special message to the Benefit Authorizer (BA).

When the decision maker approved the fee agreement in a claim, take these steps:

1. a. 

   Verify through RASR that:

   • •

     If the representative is an attorney, the representative is not sanctioned and is currently qualified to be an attorney representative, per GN 03910.020B.1.; or

   • •

     If the representative is a non-attorney, the representative is not sanctioned and is eligible for direct fee payment, per GN 03920.018.

   • •

     The eligible representative has not waived the fee or direct payment of a fee; and

   • •

     If a representative has validly assigned direct payment of their authorized fee to an entity as per GN 03920.021, that entity is eligible to receive direct payment of fees and has not been placed on the IDPE list. For information on the IDPE list, see GN 03920.052.

2. b. 

   Effectuate the decision following the processing instructions in GN 03940.020C through GN 03940.020E.

3. c. 

   Send a copy of the award notice, including fee approval language, to the representative.

4. d. 

   Certify direct payment to the representative who is eligible or to an entity if there is a valid assignment, unless any qualified party or the decision maker requested administrative review.

5. e. 

   Release remaining past-due benefits to the claimant and any auxiliary beneficiaries, unless:

   • •

     A windfall offset is pending for concurrent Title II and Title XVI claims, or

   • •

     There is Federal court involvement. For court fees, refer to GN 03920.060.

Approval of a fee agreement is contingent on whether the claim results in past-due benefits. For the relevant fee agreement evaluation policy, see HALLEX I-1-2-12.

Fee agreements can be processed only if the claim, for which the fee agreement was filed, was for entitlement and resulted in past-due benefits.

Therefore, if the claim does not result in past-due benefits, send a notice advising the representative(s) and claimant, that the fee agreement cannot be processed, and the representative(s) must file a fee petition in order to charge and collect a fee.

The notice must advise the representative(s), that:

• •

  We cannot act on the prior fee agreement approval and must rescind the approval.

• •

  The representative still needs to have our approval to charge and collect a fee; include paragraphs ATY817, ATYR03, and 160 in the notice with other required paragraphs and send a copy of the notice to the servicing FO in concurrent Titles II and XVI cases.

Processing instructions:

• •

  NOT2 for Fee Agreement Type — Leave blank.

  • –

    MCS will automatically code ATY04 to the DW01 when NOT2 "Fee Agreement Type" is blank.

• •

  NOT2 for FEE Agreement % — Leave blank.

• •

  NOT2 for FEE Agreement Amount — Leave blank.

• •

  NOT2 for Last Withholding Date Code the month before the month of adjudication, see GN 03920.030B.

• •

  On the DW01 screen, receipt in the automatic ATY04 with "XXXXXX."

• •

  Add a new issue for ATY00.

  • –

    Add the remark "no past due benefits" next to the ATY00 issue.

• •

  Add an RPOC to the document disapproval of the fee agreement because no past-due benefits are involved.

• •

  The notice must advise the claimant and the representative that the representative must file a fee petition to charge and collect a fee.

  • –

    NOT3 screen, add ATYR03.

• •

  Delete the automated 098/099 diary on the DECI screen, since there are no past-due benefits. SSA will not control cases that do not result in past-due benefits.

• •

  Add a special message to the record showing the representative's name and add the remark, "Case resulted in no past-due benefits, fee petition, fee paid by claimant."

  • –

    After adjudicating the claim via MCS EC, the next day the technician will add a special message to the record showing the representative's name and remark, "Case resulted in no past-due benefits, fee petition, fee paid by claimant."

  • –

    For cases adjudicated via MACADE, technicians will provide the special message to the BA.

When the decision maker disapproved the fee agreement in the claim, and a representative is eligible for direct payment of fees:

• •

  Effectuate the decision as a fee petition case;

• •

  Withhold 25 percent of the past-due benefits;

• •

  Do not include a paragraph stating the fee agreement is disapproved in the notice of award.

The ALJ or AC decision notice contains language advising the claimant and representative(s) of the disapproved fee agreement and administrative review rights.

1. a. 

   If the attorney adviser, ALJ, or AAJ did not make a determination on the fee agreement, do not delay effectuating the decision. Take the following actions:

   • •

     Process the claim.

   • •

     Verify through RASR that:

     • –

       If the representative is an attorney, the representative is not sanctioned and is currently qualified to be an attorney representative, per GN 03910.020B.1.; or

     • –

       If the representative is a non-attorney, the representative is not sanctioned and is eligible for direct fee payment, per GN 03920.018.

     • –

       The eligible representative has not waived the fee or direct payment of a fee; and

     • –

       If an eligible representative has validly assigned direct payment of their authorized fee to an entity as per GN 03920.021, that entity is eligible to receive direct payment of fees and has not been placed on the IDPE list.

   • •

     Withhold 25 percent of past-due benefits if any representative on the claim is eligible for and did not waive direct payment or if there is Federal court involvement.

   • •

     Request an incomplete notice in MCS. For instructions, see NL 00725.003.

   • •

     Use the "neutral" language paragraphs regarding the representative's fees. For language, refer to GN 03940.075. Do not include the paragraphs mentioning the fee petition process in the notice.

2. b. 

   Contact the appropriate office depending on who issued the fully or partially favorable decision. Contact the Office of Hearing Operations (OHO) if an ALJ or Attorney Advisor issued the decision; or contact the Attorney Fee Branch (AFB) in the Office of Appellate Operations (OAO) if an AAJ issued the decision.

   In order to obtain a signed determination on the fee agreement:

   • •

     Refer to the following chart to email a memo to the appropriate hearing office (HO) control box (cc the ALJ and the Hearing Office Director (HOD)) or OAO’s AFB with the date of the fully or partially favorable decision and a reference to the fee agreement in eView. Prior to sending a follow-up, review the claim(s) file to ensure the fee agreement determination has not been added. For sample language, see GN 03905.065B.3.

   • •

     In the email, advise OHO or OAO’s AFB whether an exception to the fee agreement process exists and, if so, which one(s). For exceptions to the fee agreement process, see GN 03940.003D.

   • •

     Document and report (by scanning into eView or otherwise adding to the claim(s) file) any contact with OHO or OAO, including emails about the status of the fee determination.

   • •

     When you receive the determination on the fee agreement, proceed as instructed.

   Refer to the chart for contacts and diaries.

   PC Action	ALJ (OHO)	AAJ (OAO/AFB)
   Initial contact Diary for 7 days.	• Send an email message to the HO control email box. • cc the ALJ and the HOD. • Use OHO Fee Contacts to obtain the HO control email box information and the name of the HOD.	• Contact OAO's AFB by • email by sending an email message to ^DCARO OAO ATTY FEE BR.
   First follow-up Diary for 15 days.	If you do not receive an acknowledgment: • Send a follow-up email to the HO control email box • cc the ALJ and the HOD.	If you did not receive an acknowledgment, follow-up with an email:
   Second follow-up Diary for 30 days.	• Send an email to the Regional Office (RO) control email box. • Cc the HOD, ALJ and HO control email box, see language in GN 03905.065B.3. • In the follow-up email, refer to the fee agreement and copies of earlier emails scanned to eView. • The OHO Fee Contacts provides RO control email box information, HO codes within the respective RO jurisdictions and a link to each HO's webpage and Office of Directory with the names of each office's HOD.	Send a follow-up email to the AFB to ^DCARO OAO ATTY FEE BR.
   Third follow-up Diary for 30 days. (Continue to email reminders until you receive a decision on the fee agreement.)	• Send an email to the Office of the Chief ALJ (OCALJ) at ^OHO OCALJ Delayed Fee Agreement Protest • Ask OCALJ to follow up on the request. • Include the prior emails you sent to the HO and the RO in the email you send to OCALJ.	• Send earlier emails to the AFB • Request they follow up. • Include a summary or documentation of previous follow-up actions and the PC contact name and phone number.

Challenge the fee agreement approval if there may be a reason to find that the attorney adviser, ALJ, or AAJ incorrectly approved a fee agreement, such as:

• •

  The fee agreement does not meet the requirements of the Act, as explained in GN 03940.003B; or

• •

  An exception to the fee agreement process applies, as explained in GN 03940.003D.

Subsequent handling of the representative fee ACR depends on both:

• •

  The means by which the fully or partially favorable decision is effectuated, and

• •

  Whether we can pay the fee immediately.

The local PC instructions may call for slightly different routing.